PATRICIA L JACKSON (NPI# 1376557702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1376557702 |
Entity Type | Individual |
Full Name | PATRICIA L JACKSON |
Other Name | PATRICIA TRETHEWEY |
Credential | FNP |
Practice Address |
230 W Catalpa Dr Suite D Mishawaka IN 46545-8321 |
Mailing Address |
230 Catalpa Suite D Mishawaka IN 46545 |
Practice Telephone | 5742577551 |
Practice Fax Number | 5742577535 |
Mailing Telephone | 5742577551 |
Mailing Fax Number | 5742577535 |
Enumeration Date | 2006-07-28 |
Last Update Date | 2019-07-05 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71001911A | IN | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | 200519100 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104458496 | Patricia A Jackson | Behavior Technician | 10252 S Hwy 441, Unit 3, Belleview, FL 34420 | 2020-02-05 |
1003396185 | Patricia Jackson | Licensed Vocational Nurse | 24310 Forest Canopy Dr, Katy, TX 77493-3088 | 2018-08-17 |
1023377967 | Patricia Renee Jackson | Dentist | 191 Highway and Hospital Road, Chinle, AZ 86503 | 2012-05-13 |
1306059548 | Patricia L Jackson | Home Health Aide | 11379 E Pike Rd, Cambridge, OH 43725-9162 | 2007-05-07 |
1902027329 | Patricia Jackson | Physical Therapist | 307 7th St E, Lehigh Acres, FL 33936-3970 | 2007-05-02 |
1396888335 | Patricia Ann Jackson | Social Worker | 420 Mink Pl, Abingdon, VA 24210-3426 | 2007-02-15 |
1427132422 | Patricia Suzanne Jackson | Family Medicine | 225 Von Karman Ave, Tullahoma Va Clinic, Arnold Afb, TN 37389 | 2006-10-25 |
1710081823 | Patricia Ann Jackson | Chiropractor | 225 3rd St, Batesville, AR 72501 | 2006-09-11 |
1073525150 | Patricia L Jackson | Nurse Practitioner | 1252 N 22nd St Unit A, Laramie, WY 82072-5306 | 2006-08-13 |
1225094154 | Patricia Mcgarvey Jackson | Physician Assistant | 6800 Southpoint Pkwy, Suite 200, Jacksonville, FL 32216-6257 | 2006-04-20 |
Street Address |
230 W CATALPA DR SUITE D |
City | MISHAWAKA |
State | IN |
Zip Code | 46545-8321 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598013559 | Dung Trina La | Pharmacist | 230 W Catalpa Dr, Mishawaka, IN 46545-8321 | 2012-08-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649824103 | Senior Helpers | In Home Supportive Care | 230 Catalpa Drive Suite B, Mishawaka, IN 46545 | 2019-08-01 |
1093272114 | Candice Marie Greathouse | Physical Therapy Assistant | 3630 Hickory Road, Mishawaka, IN 46545 | 2019-02-25 |
1639662596 | Mishawaka Rcf Lp | Assisted Living Facility | 3630 Hickory Rd, Mishawaka, IN 46545 | 2018-06-14 |
1760907299 | Timothy John Howard | Emergency Medicine | 610 1/2 N Main Street, Apartment 1, Mishawaka, IN 46545 | 2017-08-05 |
1699203612 | Paridhie Vasudevan | Dentist | 6502 Grape Rd Ste 882, Mishawaka, IN 46545 | 2017-06-03 |
1780134650 | Ossip Optometry, PC | Optometrist | 5111 N. Main Street, Suite 200, Mishawaka, IN 46545 | 2016-10-04 |
1457730038 | Melissa Anne Douthit | Nurse Practitioner | 3665 Park Pl W Ste 300, Mishawaka, IN 46545 | 2015-05-28 |
1558759654 | Spine and Joint Associates of Plymouth, Inc | Chiropractor | 229 Red Coach, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
1609264795 | Spine and Joint Associates of Mishawaka, Inc | Chiropractor | 229 Red Coach Trail, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
1508260795 | Maribel Smith | Counselor | 2989 Heritage Ct, Mishawaka, IN 46545 | 2014-10-16 |
Find all providers in zip 46545 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467092908 | Tori Driver | Nurse Practitioner | 3005 Grape Rd Ste B, Mishawaka, IN 46545-2709 | 2020-01-13 |
1093272593 | Regina Lynn Yoder | Nurse Practitioner | 303 S Main St Ste 111, Mishawaka, IN 46544-2159 | 2019-02-21 |
1376021725 | Kaley Michelle Marino | Nurse Practitioner | 1113 Mossy Ln, Mishawaka, IN 46544-9055 | 2018-07-29 |
1386192870 | Melinda C Nwanganga | Nurse Practitioner | 4501 Lincolnway E, Mishawaka, IN 46544-4035 | 2016-09-14 |
1760835912 | Ophelia Ansari | Nurse Practitioner | 4501 Linconway East, Mishawaka, IN 46544 | 2016-07-22 |
1457730038 | Melissa Anne Douthit | Nurse Practitioner | 3665 Park Pl W Ste 300, Mishawaka, IN 46545 | 2015-05-28 |
1578692794 | Lynn Davis Figg | Nurse Practitioner | 611 East Douglas Road, Suite 405, Mishawaka, IN 46545-1468 | 2007-03-05 |
1467406074 | Saint Joseph Regional Medical Center, Inc. | Nurse Practitioner | 60101 Bodnar Blvd Ste 100b, Mishawaka, IN 46544-9340 | 2006-05-19 |
1518955327 | Tori Dawn Clabaugh | Nurse Practitioner | 316 Indian Ridge Blvd, Mishawaka, IN 46545-9034 | 2005-10-06 |
1134129919 | Jena M Corban | Nurse Practitioner | 270 E Day Rd, Suite 280, Mishawaka, IN 46545-3444 | 2005-07-22 |
Find all providers in MISHAWAKA |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.